Individual
THOMAS JAY MARQUARDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
60 NORTH THIRD STREET, GRANBY, CO 80446-0090
(970) 887-2459
Mailing address
PO BOX 90, GRANBY, CO 80446-0090
(970) 887-2459
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPTOMETRY902
CO
Other
Enumeration date
09/28/2007
Last updated
09/28/2007
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